ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Hrvoje Gasparovic
Sary F. Aranki
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gasparovic, H.
Right arrow Articles by Aranki, S. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gasparovic, H.
Right arrow Articles by Aranki, S. F.
Related Collections
Right arrow Extracorporeal circulation

Ann Thorac Surg 2004;78:e89-e91
© 2004 The Society of Thoracic Surgeons

Case report

Severe Argatroban-Induced Coagulopathy in a Patient With a History of Heparin-Induced Thrombocytopenia

Hrvoje Gasparovic, MDa, Nadia S. Nathan, MDa, Daniel Fitzgerald, CCPb, Sary F. Aranki, MDa,*

a Division of Cardiac Surgery, Boston, Massachusetts, USA
b Division of Anesthesia, Brigham and Women's Hospital, Boston, Massachusetts, USA

Accepted for publication April 12, 2004.

* Address reprint requests to Dr Aranki, Division of Cardiac Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115 USA
saranki{at}partners.org

Heparin-induced thrombocytopenia is a serious complication of heparin therapy, and it remains a therapeutic challenge in the subset of patients requiring cardiopulmonary bypass. Alternative anticoagulation strategies include lepirudin, danaparoid, bivalirudin, and argatroban, or a combination of unfractionated heparin with a platelet antagonist. Argatroban is eliminated by a hepatic route, making it a practical option for patients with renal insufficiency. However, the lack of an effective antidote poses a significant problem. We present a patient with a history of heparin-induced thrombocytopenia with thrombosis who underwent a redo aortic valve replacement. Although the level of anticoagulation achieved with argatroban was initially adequate, its persistence after the completion of cardiopulmonary bypass proved to be life threatening.




This article has been cited by other articles:


Home page
 BloodHome page
S. T. Olson, R. Swanson, and M. Petitou
Specificity and selectivity profile of EP217609: a new neutralizable dual-action anticoagulant that targets thrombin and factor Xa
Blood, March 8, 2012; 119(10): 2187 - 2195.
[Abstract] [Full Text] [PDF]

Home page
 Interact CardioVasc Thorac SurgHome page
F. Follis, G. Filippone, G. Montalbano, M. Floriano, E. LoBianco, G. D'Ancona, and M. Follis
Argatroban as a substitute of heparin during cardiopulmonary bypass: a safe alternative?
Interact CardioVasc Thorac Surg, April 1, 2010; 10(4): 592 - 596.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
L. E. Samuels, J. Kohout, E. Casanova-Ghosh, K. Hagan, P. Garwood, F. Ferdinand, and S. M. Goldman
Argatroban as a Primary or Secondary Postoperative Anticoagulant in Patients Implanted With Ventricular Assist Devices
Ann. Thorac. Surg., May 1, 2008; 85(5): 1651 - 1655.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2004 by The Society of Thoracic Surgeons.